The development and publication of Diagnostic and Statistical Manual of

produced a peak in mainstream media interest in psychiatry, and a large and gen-erally critical set of scientific commentar-ies. The coverage has focused mainly on the expansion of some categories, and loosening of some criteria, which together may lead to more people receiving diag-noses, and accompanying accusations of the medicalisation of normal living. Instructions given to members of DSM-5 work groups appear to have encouraged this.1 This has not been the only source of disquiet. The influence of the pharmaceut-ical industry on the members of the appointees to DSM diagnostic work groups, which constructed the new rubrics, has caused concern,2 as remuneration and insurance coverage in the USA depends partly on DSM diagnosis, and the pharma-ceutical industry has been accused of encouraging the development of new diag-noses as a way to increase profitability.3 Societal impact has been an explicit part of the development of DSM-5, as outlined in the article in this issue.4 Reasons for deci-sions by DSM-5 workgroups have included enabling sufferers to receive treatment which would not be available without a DSM diagnosis (a local US concern), or encouraging people to seek help. These have been instrumental in the creation of new diagnoses, and in some cases such reasons have been held to substitute for sci-entific evidence.4 The membership of the various groups involved in constructing DSM-5 was appointed overwhelmingly from among US clinicians; unlike International Classification of Diseases (ICD), DSM is aimed at the US market, although it is used much more widely. In some cases, experts walked out, leading for example to the loss of all non-US members of th